The Accumulation of Visceral Adipose Tissue may be Influenced by Intra-Abdominal Temperature

Despite the established link between visceral obesity and major chronic diseases, little is known about physiologic factors that directly and specifically lead to the accumulation of visceral fat. I hypothesize that reduced intra-abdominal temperature might be a physical factor underlying the partitioning of adipose tissue to the intra-abdominal region rather than the periphery. The hypothesis is supported by biochemical reports that rat and bovine lipoprotein lipase have increased activity when incubated at lower temperatures. Persons exercising in cool water have been found to preserve subcutaneous fat whereas comparable exercise without local cooling results in subcutaneous fat loss. Pima Indians, a group that commonly acquires extreme levels of visceral fat, have been found to have lower intraabdominal temperatures during sleep than weight-matched European-Americans. In a study of four young men and four young women, I have noted that mean intra-abdominal basal temperatures were higher for women than men (36.51 ± 0.18°C vs. 35.91 ± 0.11°C; p = .0014). Since the men are more likely to acquire visceral obesity at later age, this also provides support for my hypothesis. Investigators might wish to examine further the temperature dependence of adipose-tissue lipoprotein lipase, the temperature variation between sites of adipose tissue, and the effects of foods, physical activities, smoking and drugs on localized body temperature.     

Mechanisms of cold pain

Avoidance of cold pain is an important survival mechanism. Intriguingly, whilst cooling can cause numbness, damage sensing mechanisms still seem to operate at low temperatures, and pain can be perceived from cooled damaged tissue. Recent studies have identified two cold-activated transient receptor potential (TRP) channels present in sensory neurons as transducers of cold stimuli. TRPM8 seems to mediate responses to cooling whilst TRPA1 is activated, possibly indirectly, by more extreme cold conditions. The existence of cold-responsive neurons that do not express these channels suggests that other transducers of cold stimuli remain to be discovered. Subsequent action potential electrogenesis and probably propagation from sensory neurons innervating cold tissues depends upon the presence of Na(v)1.8, the sole voltage-gated sodium channel that fails to inactivate at low temperatures. This may explain the remarkable specificity of Na(v)1.8 expression in nociceptive neurons, where it plays an important role in pain pathways.     

Monitoring of whole body cryotherapy effects by thermal imaging: preliminary report

In whole body cryotherapy the whole human body is exposed to low temperature below −100°C in a special room called cryogenic chamber for a very short period of time (2–3 minutes). The impact of cold can cause many different biochemical and physiological reactions of the organism.The skin temperature response due to whole body cryotherapy was studied by means of infrared measurements. The thermograms of chosen body parts of patients suffering from low back pain were performed before and after whole body cooling on the 1^st, 5^th and the last (10^th) day of medical treatment. Infrared imaging performed after cold impact owing to the enhancement of the skin temperature profile may reveal a slight decrease of the inflammatory states as a result of the 10 sessions of cryotherapy.     

Clinical implications of macrophage dysfunction in the development of osteoarthritis of the knee

Osteoarthritis (OA) is the most common form of arthritic disease, leading to disability and impaired quality of life and no curative treatments exist. Increasing evidence indicates that low-grade inflammation plays a pivotal role in the onset and progression of OA. In this review, we summarize emerging findings on the pathological roles of synovial macrophages, adipose tissue macrophages, and osteoclasts in OA and their potential clinical implications from cell biology to preclinical and preliminary clinical trials. The failure of synovial macrophages to transition from pro-inflammatory M1 to anti-inflammatory M2 subtypes may contribute to the initiation and maintenance of synovitis in OA. M1 macrophages promote the inflammatory microenvironment and progression of OA through interactions with synovial fibroblasts and chondrocytes, thus increasing the secretion of matrix metalloproteinases. Direct inhibition of M1 or promotion of M2 polarization may be useful therapeutic interventions. Adipose tissue macrophages present in the infrapatella fat pad (IPFP) were involved in the progression of obesity-induced OA, which contributed to changes in the integrity of the IPFP. Furthermore, macrophages and osteoclasts in the subchondral bone were involved in bone remodeling and pain through uncoupled osteoclast/osteoblast activity and increased nociceptive signaling. Growing evidence has indicated an important role for macrophage-mediated low-grade inflammation in OA. Fully understanding the link between macrophages and other cells in joints will provide new insights into OA disease modification.     

The use of thermal imaging in assessing skin temperature following cryotherapy: a review

Background

Cryotherapy is used in various clinical and sporting settings to reduce odema, decrease nerve conduction velocity, decrease tissue metabolism and to facilitate recovery after exercise induced muscle damage. The basic premise of cryotherapy is to cool tissue temperature and various modalities of cryotherapy such as whole body cryotherapy, cold spray, cryotherapy cuffs, frozen peas, cold water immersion, ice, and cold packs are currently being used to achieve this. However, despite its widespread use, little is known regarding the effectiveness of different cryotherapy modalities to reduce skin temperature.

Objectives

To provide a synopsis of the use of thermal imaging as a method of assessing skin temperature following cryotherapy and to report the magnitude of skin temperature reductions associated with various modalities of cooling.

Design

Structured narrative review.

Methods

Three electronic databases were searched using keywords and MESH headings related to the use of thermal imaging in the assessment of skin temperature following cryotherapy. A hand-search of reference lists and relevant journals and text books complemented the electronic search.

Summary

Nineteen studies met the inclusion criteria. A skin temperature reduction of 5–15 °C, in accordance with the recent PRICE (Protection, Rest, Ice, Compression and Elevation) guidelines, were achieved using cold air, ice massage, crushed ice, cryotherapy cuffs, ice pack, and cold water immersion. There is evidence supporting the use and effectiveness of thermal imaging in order to access skin temperature following the application of cryotherapy.

Conclusions

Thermal imaging is a safe and non-invasive method of collecting skin temperature. Although further research is required, in terms of structuring specific guidelines and protocols, thermal imaging appears to be an accurate and reliable method of collecting skin temperature data following cryotherapy. Currently there is ambiguity regarding the optimal skin temperature reductions in a medical or sporting setting. However, this review highlights the ability of several different modalities of cryotherapy to reduce skin temperature.     

In vitro model systems for evaluation of smooth muscle cell response to cryoplasty

Restenosis is a major health care problem, with approximately 40% of angioplasties resulting in restenosis. Mechanisms related to elastic recoil, cell proliferation, and extracellular matrix (ECM) synthesis are implicated. In vivo studies have demonstrated the potential for cryotherapy to combat the process of restenosis, but the mechanisms whereby freezing and/or cooling can reduce or eliminate smooth muscle cell (SMC) proliferation and ECM synthesis are not well known. While in vivo testing is ultimately necessary, in vitro models can provide important information on thermal parameters and mechanisms of injury. However, it is important to carefully choose the model system for in vitro work on cryoinjury characterization to adequately reflect the clinical situation. In this study, we examined the differences in response to cryoinjury by SMCs from different species (rat, pig, and human) and in different cellular environments (suspension vs. tissue equivalent). Tissue equivalents, composed of cells embedded in collagen or fibrin gel, provide a 3-D tissue-like environment, while allowing for controlled composition. As reported here, all SMCs showed similar trends, but rat cells appeared less sensitive to cooling at faster cooling rates in suspension, while human SMCs were less sensitive to temperatures just above freezing when embedded in collagen. In addition, the SMCs were less sensitive in suspension than they were in collagen. Cells in suspension exhibited 70% viability at -11 degrees C, whereas cells in the tissue equivalent model showed only 30% survival. Future studies will aim to more adequately represent the conditions in restenosis by providing inflammatory and proliferative cues to the cells.     

Avoidance of intracellular freezing by the freezing-tolerant New Zealand Alpine weta Hemideina maori (Orthoptera: Stenopelmatidae)

Calorimetric analysis indicates that 82% of the body water of Hemideina maori is converted into ice at 10 degrees C. This is a high proportion and led us to investigate whether intracellular freezing occurs in H. maori tissue. Malpighian tubules and fat bodies were frozen in haemolymph on a microscope cold stage. No fat body cells, and 2% of Malpighian tubule cells froze during cooling to -8 degrees C. Unfrozen cells appeared shrunken after ice formed in the extracellular medium. There was no difference between the survival of control tissues and those frozen to -8 degrees C. At temperatures below -15 degrees C (lethal temperatures for weta), there was a decline in survival, which was strongly correlated with temperature, but no change in the appearance of tissue. It is concluded that intracellular freezing is avoided by Hemideina maori through osmotic dehydration and freeze concentration effects, but the reasons for low temperature mortality remain unclear. The freezing process in H. maori appears to rely on extracellular ice nucleation, possibly with the aid of an ice nucleating protein, to osmotically dehydrate the cells and avoid intracellular freezing. The lower lethal temperature of H. maori (-10 degrees C) is high compared to organisms that survive intracellular freezing. This suggests that the category of 'freezing tolerance' is an oversimplification, and that it may encompass at least two strategies: intracellular freezing tolerance and avoidance.     

Depressed thermogenesis but competent brown adipose tissue recruitment in mice devoid of all hormone-binding thyroid hormone receptors

We have examined the metabolic role of hormone-binding nuclear thyroid hormone receptors (TRs). Mice devoid of all hormone-binding TRs [TR alpha 1(-/-)beta(-/-) (TR-ablated mice)] had slightly decreased body temperature and much decreased basal metabolic rate, were still able to markedly increase metabolic rate in the cold, but were cold intolerant due to inadequate total heat production at low temperatures. A standard norepinephrine test showed that adrenergically induced thermogenesis could not be activated normally in the TR-ablated mice. This was not due to inadequate recruitment of brown adipose tissue, nor to the absence, decreased recruitment or dysfunction of the uncoupling protein-1. However, isolated brown fat cells were 10-fold desensitized, explaining the lack of response to standard adrenergic stimuli; cell culture experiments demonstrated that this desensitization was not an innate effect. Thus, the cold intolerance was probably not due to inadequate sympathetically induced nonshivering thermogenesis. Additionally, the results indicated that no metabolic effects of thyroid hormones could become manifest in the absence of nuclear TRs, that ligand-bound TRs were needed for euthermia and eumetabolism, but that TRs per se were not required for brown adipose tissue recruitment and uncoupling protein-1 gene expression.     

Influence of low ambient temperature and dietary lipids on adipose tissue and plasma fatty acid composition of the Japanese quail.

Japanese quail were maintained on synthetic diets containing 15% corn oil, 15% tallow, and zero fat, and were later exposed at 3.5 degrees C for 21 days. A distinct influence of dietary fat composition upon the adipose tissue triglyceride fatty acid composition was detected, but no change in fatty acid composition was produced with cold exposure. The fatty acid composition of adipose tissue from quail acclimatized to winter temperatures showed no trend towards a greater degree of unsaturation. There was no evidence of a gross selective mobilization of certain fatty acids from the depot lipids. Regional variation in the fatty acid composition of avian fats is discussed with respect to the level of food intake and body temperature.     

Effect of cooling to low temperatures on viability of human skin keratinocytes at different stages of differentiation

The goal of this study was to conduct a comparative analysis of the degree of resistance to low temperatures of human epidermal cells found at different stages of differentiation. The action of liquid-nitrogen vapors was analyzed in experiments in vitro at various temperature regimes on fragments of the human integral skin and on isolated from them and cultivated keratinocytes. The degree of resistance of keratinocytes to the action of cooling to low temperatures was evaluated by their ability to form a multilayer stratum in culture, which indicates the preservation of the viability of the cells treated with cold. This approach allowed one to reveal the diapason of optimal regimes of the action of low temperatures on cells in the composition of tissue and after their conversion into culture. The quantitative ratios of the epidermal stem, transitory, and differentiated cells in a population of viable cells before and after exposure to low temperatures were determined with antibodies that correspond to their different stages of differentiation. The degree of resistance of keratinocytes to action of cooling to low temperatures was evaluated by their ability to form a multilayer stratum in culture, which indicates preservation of viability of the cells treated with cold. The results of this study show that the resistance of human epidermal cells to low temperature differs depending on their stage of differentiation both in situ and in vitro. The epidermal stem and transitory cells are more stable than the differentiated cells.     

Application of mesenchymal stem cell therapy for the treatment of osteoarthritis of the knee: A concise review

Osteoarthritis(OA) refers to a chronic joint disease characterized by degenerative changes of articular cartilage and secondary bone hyperplasia. Since articular cartilage has a special structure, namely the absence of blood vessels as well as the low conversion rate of chondrocytes in the cartilage matrix, the treatment faces numerous clinical challenges. Traditional OA treatment(e.g., arthroscopic debridement, microfracture, autologous or allogeneic cartilage transplantation,chondrocyte transplantation) is primarily symptomatic treatment and pain management, which cannot contribute to regenerating degenerated cartilage or reducing joint inflammation. Also, the generated mixed fibrous cartilage tissue is not the same as natural hyaline cartilage. Mesenchymal stem cells(MSCs) have turned into the most extensively explored new therapeutic drugs in cell-based OA treatment as a result of their ability to differentiate into chondrocytes and their immunomodulatory properties. In this study, the preliminary results of preclinical(OA animal model)/clinical trials regarding the effects of MSCs on cartilage repair of knee joints are briefly summarized, which lay a solid application basis for more and deeper clinical studies on cell-based OA treatment.     

Cellular changes during cold acclimatation in adipose tissues

Cold exposure is a well-known physiological stimulus that activates the sympathetic nervous system and induces brown adipose tissue (BAT) hyperplasia. The effects of cold exposure or cold acclimatation have been extensively studied in interscapular BAT (IBAT). However, it has been recently shown that brown adipocytes are present in adipose deposits considered as white fat such as periovarian (PO) fat pad. We have investigated the kinetic of brown precursor recruitment in adipose tissues using DNA measurement and specific marker expression. In IBAT, cold exposure induces proliferation of precursor cells and differentiation into preadipocytes characterized by the expression of A2COL6, a marker specific to early steps of the differentiation process. A chronic stimulation of the tissue is necessary to observe the full effect. In PO fat pad, no proliferation can be detected, whereas differentiation of brown preadipocytes and maybe phenotypic conversion of white adipocytes seems to be promoted. In conclusion, these data demonstrated that 1) the same stimulus (cold exposure) does not induce the same response in terms of preadipocyte proliferation and differentiation in periovarian and brown adipose tissues, although both contain brown adipocytes, and 2) preadipocyte recruitment in adipose tissues after cold exposure depends on the predominant type of fat cells. © 1996 Wiley-Liss, Inc.     

Fat, Energy and Mammalian Survival

Adipose tissue plays a critical role in mammalian life historystrategies, serving as an organ for the storage of food andenergy, as a source of heat and water and as thermal insulation.The food and energy storage roles are especially important inallowing the animals to survive food shortages and stressesassociated with competition for mates, territorial defense,gestation and lactation, and to accomplish migrations. The composition,cellularity and anatomical site of adipose depots in a mammalcan influence both the amount of fat stored and its availabilityand usefulness in any given situation. The fatty acids and complexlipids in adipose tissue, blood vessels, nerves and brain changein response to ambient temperature and the low body temperaturesduring hibernation. Early nutrition may influence the numberof fat cells developed by a mammal, and thus affect its abilityto survive adversity. Desert species develop localized depotswhich will not interfere with temperature regulation, whileanimals in cold environments use their extensive superficialfat layers as insulation.     

Syndecan-1 Is Required to Maintain Intradermal Fat and Prevent Cold Stress

Homeostatic temperature regulation is fundamental to mammalian physiology and is controlled by acute and chronic responses of local, endocrine and nervous regulators. Here, we report that loss of the heparan sulfate proteoglycan, syndecan-1, causes a profoundly depleted intradermal fat layer, which provides crucial thermogenic insulation for mammals. Mice without syndecan-1 enter torpor upon fasting and show multiple indicators of cold stress, including activation of the stress checkpoint p38α in brown adipose tissue, liver and lung. The metabolic phenotype in mutant mice, including reduced liver glycogen, is rescued by housing at thermoneutrality, suggesting that reduced insulation in cool temperatures underlies the observed phenotypes. We find that syndecan-1, which functions as a facultative lipoprotein uptake receptor, is required for adipocyte differentiation in vitro. Intradermal fat shows highly dynamic differentiation, continuously expanding and involuting in response to hair cycle and ambient temperature. This physiology probably confers a unique role for Sdc1 in this adipocyte sub-type. The PPARγ agonist rosiglitazone rescues Sdc1−/− intradermal adipose tissue, placing PPARγ downstream of Sdc1 in triggering adipocyte differentiation. Our study indicates that disruption of intradermal adipose tissue development results in cold stress and complex metabolic pathology.     

The emerging role of fibroblast‐like synoviocytes‐mediated synovitis in osteoarthritis: An update

Osteoarthritis (OA), the most ubiquitous degenerative disease affecting the entire joint, is characterized by cartilage degradation and synovial inflammation. Although the pathogenesis of OA remains poorly understood, synovial inflammation is known to play an important role in OA development. However, studies on OA pathophysiology have focused more on cartilage degeneration and osteophytes, rather than on the inflamed and thickened synovium. Fibroblast‐like synoviocytes (FLS) produce a series of pro‐inflammatory regulators, such as inflammatory cytokines, nitric oxide (NO) and prostaglandin E₂ (PGE₂). These regulators are positively associated with the clinical symptoms of OA, such as inflammatory pain, joint swelling and disease development. A better understanding of the inflammatory immune response in OA‐FLS could provide a novel approach to comprehensive treatment strategies for OA. Here, we have summarized recently published literatures referring to epigenetic modifications, activated signalling pathways and inflammation‐associated factors that are involved in OA‐FLS‐mediated inflammation. In addition, the current related clinical trials and future perspectives were also summarized.     

结缔组织铺片脂肪组织油红染色在组织学实验教学中的应用

目的在传统结缔组织铺片基础上开展脂肪组织油红染色方法在医学本科生组织学实验教学中的应用。方法学生先进行疏松结缔组织铺片,并施行脂肪组织油红o-甲苯胺兰-伊红三重染色,然后镜下观察。结果油红o染色把结缔组织中的脂肪细胞内脂滴保存下来并染上红色。脂肪组织中央的细胞脂滴均匀红染,充满胞浆,周边的脂肪细胞胞浆中油红染色很少,细胞呈空泡状,显示出脂肪细胞亚群存在。甲苯胺兰染色使得疏松结缔组织中肥大细胞染成紫红色,胞核染色浅,细胞数量多、成群分布。伊红可使得结缔组织内除脂肪细胞、肥大细胞意外的其他细胞的胞浆和胶原纤维染成淡红色。结论传统的组织学平铺片技术基础上引入脂肪油红o-甲苯胺兰-伊红三重染色,可增强学生动手能力,并能很好地了解输送结缔组织中细胞的不同表型和分布,丰富组织学内容,把教学、科研连接一起,达到提高实验教学质量的目的。     

Heart-type fatty acid-binding protein is essential for efficient brown adipose tissue fatty acid oxidation and cold tolerance

Brown adipose tissue has a central role in thermogenesis to maintain body temperature through energy dissipation in small mammals and has recently been verified to function in adult humans as well. Here, we demonstrate that the heart-type fatty acid-binding protein, FABP3, is essential for cold tolerance and efficient fatty acid oxidation in mouse brown adipose tissue, despite the abundant expression of adipose-type fatty acid-binding protein, FABP4 (also known as aP2). Fabp3(-/-) mice exhibit extreme cold sensitivity despite induction of uncoupling and oxidative genes and hydrolysis of brown adipose tissue lipid stores. However, using FABP3 gain- and loss-of-function approaches in brown adipocytes, we detected a correlation between FABP3 levels and the utilization of exogenous fatty acids. Thus, Fabp3(-/-) brown adipocytes fail to oxidize exogenously supplied fatty acids, whereas enhanced Fabp3 expression promotes more efficient oxidation. These results suggest that FABP3 levels are a determinant of fatty acid oxidation efficiency by brown adipose tissue and that FABP3 represents a potential target for modulation of energy dissipation.     

CYTOLOGICAL RESPONSES OF BROWN FAT TISSUE IN COLD-EXPOSED RATS

In young adult laboratory rats exposed to cold (6°C) the brown adipose tissue undergoes time-dependent increases in cellularity, vascular supply, and total mass. These changes are largely complete after 16 days in the cold and concurrent generally with the development of a thermoregulatory state not greatly dependent upon shivering. Histologically the brown fat changes from a tissue having both unilocular and multilocular fat cell types to one having almost exclusively the latter. During the first 6 to 12 hours in cold, the multilocular cells lose their lipid vacuoles and decrease in size, but these features are restored to normal by 24 hours. Cell proliferation, as estimated by the DNA synthetic index method (using tritiated thymidine autoradiography), appears in the reticuloendothelial cells of the brown fat at 1 day of cold exposure, becomes maximal at 4 days, and returns to the control level by 16 days. In animals injected with tritiated thymidine on the 3rd day of cold exposure and then maintained for 1 or more additional days in the cold, autoradiographs indicate that new brown fat (multilocular) cells arise by cytogenesis from reticuloendothelial progenitor cells and not by proliferation of existing brown fat cells. Throughout this and subsequent periods, cells of the epididymal white adipose tissue slowly decrease in size. Because a thermogenic role in cold acclimation has been established for the brown fat, the reported changes are regarded as adaptive responses to a cold environment.     

Very Low Density Lipoprotein Receptor (VLDLR) Expression Is a Determinant Factor in Adipose Tissue Inflammation and Adipocyte-Macrophage Interaction

Obesity is associated with adipose tissue remodeling, characterized by adipocyte hypertrophy and macrophage infiltration. Previously, we have shown that very low density lipoprotein receptor (VLDLR) is virtually absent in preadipocytes but is strongly induced during adipogenesis and actively participates in adipocyte hypertrophy. In this study, we investigated the role of VLDLR in adipose tissue inflammation and adipocyte-macrophage interactions in wild type and VLDLR-deficient mice fed a high fat diet. The results show that VLDLR deficiency reduced high fat diet-induced inflammation and endoplasmic reticulum (ER) stress in adipose tissue in conjunction with reduced macrophage infiltration, especially those expressing pro-inflammatory markers. In adipocyte culture, VLDLR deficiency prevented adipocyte hypertrophy and strongly reduced VLDL-induced ER stress and inflammation. Likewise, cultures of primary peritoneal macrophages show that VLDLR deficiency reduced lipid accumulation and inflammation but did not alter chemotactic response of macrophages to adipocyte signals. Moreover, VLDLR deficiency tempered the synergistic inflammatory interactions between adipocytes and macrophages in a co-culture system. Collectively, these results show that VLDLR contributes to adipose tissue inflammation and mediates VLDL-induced lipid accumulation and induction of inflammation and ER stress in adipocytes and macrophages.